Impact of frailty on outcomes in acute ST‐elevated myocardial infarctions undergoing percutaneous coronary intervention

Abstract

AbstractAimsWe analyzed the impact of frailty on readmission rates for ST‐elevated myocardial infarctions (STEMIs) and the utilization of percutaneous coronary intervention (PCI) in STEMI admissions.Methods and ResultsThe 2016−2019 Nationwide Readmission Database was analyzed for patients admitted with an acute STEMI. Patients were categorized by frailty risk and analyzed for 30‐day readmission risk after acute STEMIs, PCI utilization and outcomes, and healthcare resource utilization.Qualifying index admissions were found in 584,918 visits. Low risk frailty was noted in 78.20%, intermediate risk in 20.67%, and high risk in 1.14% of admissions. Thirty‐day readmissions occurred in 7.74% of index admissions, increasing with frailty (p < 0.001). Readmission risk increased with frailty, 1.37 times with intermediate and 1.21 times with high‐risk frailty.PCI was performed in 86.40% of low‐risk, 66.03% of intermediate‐risk, and 58.90% of high‐risk patients (p < 0.001). Intermediate patients were 55.02% less likely and high‐risk patients were 61.26% less likely to undergo PCI (p < 0.001). Length of stay means for index admissions were 2.96, 7.83, and 16.32 days for low, intermediate, and high‐risk groups. Intermediate and high‐risk frailty had longer length of stay, higher total cost, and were more likely to be discharged to a skilled facility (p < 0.001).ConclusionAmong adult, all‐payer inpatient visits, frailty discerned by the hospital frailty risk score was associated with increased readmissions, increased healthcare resource utilization, and lower PCI administration.